Sexual and Reproductive Health Condition of the Client of FPAB in Bangladesh

Section 1 — Introduction

Sexual & reproductive rights are internationally recognized human rights. In addition, everyone should have this right, but many social barriers exist in society. Awareness levels are not satisfactory about sexual & reproductive health because many people still believe in superstitions and religious misconceptions. Though the knowledge of sexual and reproductive health is very important for our lives, people feel shy to discuss it openly. As a result, most of the people are in the dark about sexual & reproductive health.

23% of people in Bangladesh are adolescents. Since this issue is not being discussed openly and regularly, they do not know about the physical and mental changes of the age transition period. Some adolescents are engaged in pre-marital sexual relationships, putting them at risk of unaccepted conception. Most adolescents know very little about sexual diseases like HIV/AIDS, placing them at very high risk for this dangerous disease.

The current estimated population of Bangladesh is 127 million. Youth at the age range of 15–30 represent approximately 30% of the total population, with 16.82 million young men and 16.09 million young women. It is estimated that 12.65 million young men and 12.40 million young women live in rural areas.

Reproductive health status of young people in Bangladesh is remarkably low. Despite rapid social change, women still lag behind men in all spheres. Poverty with social and cultural prejudice, gender-based violence, lack of education, and limited access to essential health care facilities contributes to poor reproductive health. 33% of adolescent girls begin childbearing in their teenage years; about 27.4% of adolescents are already mothers of one child.

Section 2 — About FPAB

Family Planning Association of Bangladesh (FPAB) is the pioneer organization of Bangladesh which makes mass awareness about sexual & reproductive health and population growth. This organization plays a great role in family planning and spreading education about sexual & reproductive health. FPAB was established in 1953, headed by Dr. Humara Syed, initially called Family Planning Association. The name was changed to Family Planning Association of Bangladesh (FPAB) on 18 February 1972, when it gained membership of the International Planned Parenthood Federation (IPPF).

Now FPAB works as a substitute organization and helping hand of government to face national problems like population explosion and sexual & reproductive health. The head office is situated at Naya Paltan in Dhaka. The main tasks of this organization are: (1) To give family planning service. (2) To give sexual & reproductive health service. (3) Mother welfare & child care project. (4) Helping center of Family. (5) Serve the equipment of family planning. (6) Youth project. (7) Training. (8) Mass awareness.

The RHIYA project of FPAB is a component project under RHIYA Bangladesh. FPAB is implementing the project in 9 outlying districts in Bangladesh. FPAB as an affiliate of IPPF has developed its strategies based on the themes of Advocacy, Access, Abortion, Adolescent, and HIV/AIDS.

Section 3 — Operational Definitions

FPAB: Family Planning Association of Bangladesh. Founded in 1953, headed by Dr. Humara Syed. FPAB works as substitute organization and helping hand of government facing national problems of population and sexual & reproductive health. Head office: Naya Paltan, Dhaka.

Client: People who take sexual & reproductive health service from FPAB’s clinics in Dhaka city.

Sexual & Reproductive Health: In this study, sexual & reproductive health means not illness or disease alone, but physical, mental and social welfare in relation to the proper sexual and reproductive process.

Condition: Not the disease or illness of sexual & reproductive organs, but the social, cultural, custom, habit, and social situation which creates obstacles to the sexual & reproductive health process.

Section 4 — Objectives of the Study

The primary objective of this research is to know about the sexual & reproductive health condition of the client of FPAB. Specific objectives include: (1) To understand what types of problems adult males and females face in taking sexual and reproductive health service. (2) To identify the sexual and reproductive health conditions prevailing among FPAB clients. (3) To learn about the clients’ opinions regarding FPAB services and their access to those services. (4) To propose recommendations for improving service delivery, particularly for lower-income groups.

Section 5 — Methodology

Method of Research: This is a quantitative research based on sample survey methodology.

Area of Research: Two clinics from Reproductive Health Initiative for Youth in Asia (RHIYA) clinics of FPAB: the Humayra Syeda Clinic and the Shabujbug FPAB Clinic.

Sample & Sample Size: 60 respondents purposefully selected from both clinics. Respondents’ age range: 11 to 50 years.

Method of Data Collection: Necessary data collected through face-to-face interview. Questionnaire provided in Bengali. Interview duration: 20 days.

Section 6 — Findings and Analysis

A. Socio-Economic & Demographic Information

Table A.1 — Age Distribution of Respondents (n=60)

Table A.2 — Marital Status: Married 76.67%, Unmarried 23.33%.

Table A.3 — Religious Status: Muslim 95.00%, Hindu 5.00%.

Table A.4 — Occupation: Housewife 46.67%, Service worker 20.00%, Others 18.33%, Business 8.33%, Student 6.67%.

Table A.5 — Monthly Income: BDT 5,000–10,000: 58.33% — the majority of FPAB clients are from lower or middle-income groups.

B. Family Planning

50 respondents (83.33%) were eligible for family planning questions. Among these eligible respondents: 72.00% currently using contraceptives; 97.22% using temporary contraceptives; only 2.78% using a permanent method.

Table B.3 — Types of Temporary Contraceptives Used (n=35): Pill 34.29%, Injection 28.57%, Condom 22.86%, Norplant 8.57%, Other 5.71%.

In 41.67% of cases husbands made decisions about contraceptive use; wives in 16.67%; both jointly in 30.56%. 76.00% of respondents deny wanting to use permanent contraceptives in the future. 74.00% of eligible respondents had taken family planning service from another organization before coming to FPAB.

C. Safe Motherhood

41 respondents (68.33%) were eligible to answer safe motherhood questions. Problems during pregnancy: 21.95%. Baby born at proper weight: 70.73%. Received proper food & rest during pregnancy: 80.49%.

Table C.4 — Place of Delivery: Clinic 31.71%, Brick-built home 29.27%, Mud home 21.95%, Hospital 17.07%.

D. Sexual & Reproductive Health

Respondents suffering from STD/STI: 0%. Respondents with knowledge of sexual disease: 88.33%. No knowledge: 11.67%.

Table D.2.2 — Knowledge of Specific STDs (53 knowledgeable respondents): AIDS/HIV 34.59%, Gonorrhoea 23.27%, Syphilis 20.13%, Hepatitis B 18.24%, Herpes 3.77%.

All 53 respondents with STD/STI knowledge supported seeking doctor consultation when symptoms appear. 53.57% advocated for medical advice, 38.39% for disclosing the condition rather than hiding it.

Table D.5 — Opinions on Prevention of Sexual Diseases: Use condom 32.64%, Be faithful to partner 24.31%, Avoid public toilets 22.92%, Avoid risky practices 15.28%, Others 4.86%.

E. Abortion

Of 60 respondents, only 10.00% were applicable for abortion-related questions (6 respondents). Of those applicable, the study found evidence of multiple MR (Menstrual Regulation) procedures per individual, reflecting the difficulty of accessing safe legal services in Bangladesh. Abortion is not legal in Bangladesh; people undergo MR to avoid unexpected conception. Most MR is done by inexperienced or semi-experienced health workers; safe MR facilities are very few, with social and religious barriers limiting access.

Section 7 — Conclusion & Recommendations

FPAB plays a great role in the service of sexual & reproductive health in Bangladesh. General people are aware of and satisfied with their service. However, several areas require improvement. The research strongly advocates that since maximum clients of FPAB are from lower or middle-income groups, the services should be free or supported by a special program for lower-income groups.

Key recommendations: (1) Expand free or subsidized services for lower-income groups. (2) Strengthen adolescent-specific programming and BCC commodity availability in rural areas. (3) Improve safe MR facilities outside urban centres. (4) Train additional health workers in rural areas on family planning methods. (5) Increase awareness campaigns using community-based channels for adolescents aged 15–19, who constitute 22.6% of the total population. (6) Address social taboos through community education programs, particularly regarding pre-marital sexual health education.

Core finding: Awareness about sexual and reproductive health in Bangladesh has improved, but significant gaps remain in rural access, adolescent education, and safe abortion services. FPAB’s community-based approach, through its RHIYA project and IPPF affiliation, provides a strong foundation for addressing these gaps at scale.